2021-11-12T10:14:23-06:00 2020-12-31 910189318 MOSS ADAMS LLP 101 SECOND STREET SUITE 900 SAN FRANCISCO CA 94105 990 2020-01-01 951816005 BEVERLY COMMUNITY HOSPITAL ASSOCIATION BEVE 3237261222 309 WEST BEVERLY BOULEVARD MONTEBELLO CA 906404308 ALICE CHENG PRESIDENT & CEO 3237261222 2021-11-08 1 ALICE CHENG 999009999 LAUREN HAVERLOCK P00545829 4159561500 2021-11-08 3 AAL1 IAL1 2020 2022-09-23 18:48:47Z ALICE CHENG 309 WEST BEVERLY BOULEVARD MONTEBELLO CA 906404308 180010626 0 X WWW.BEVERLY.ORG X 1949 CA TO BE A LEADING INDEPENDENT, NON-PROFIT COMMUNITY HOSPITAL IMPROVING THE QUALITY OF LIFE OF ITS CONSTITUENTS THROUGH HEALTH EDUCATION, DISEASE PREVENTION, AND STATE OF THE ART ILLNESS AND INJURY TREATMENT. 13 12 1072 22 0 0 157810 13095196 188692504 165991304 85829 105326 1054143 818800 189990286 180010626 0 0 0 0 69189754 71246517 0 0 0 124975231 112132761 194164985 183379278 -4174699 -3368652 203383884 209889423 122474844 132337491 80909040 77551932 TO PROVIDE COMPASSIONATE AND QUALITY HEALTH CARE. 0 0 119940246 0 138742883 INPATIENT AND OUTPATIENT HOSPITAL SERVICES - HOSPITAL SERVICES PROVIDED BY BEVERLY COMMUNITY HOSPITAL ASSOCIATION INCLUDED 8,143 INPATIENT ADMISSIONS, 13,461 OUTPATIENT VISITS, AND 31,055 EMERGENCY ROOM VISITS IN 2020. CARE IS PROVIDED WITHOUT CHARGE TO PATIENTS WHO MEET SPECIFIED CRITERIA UNDER THE CHARITY CARE POLICY. THE COST OF CHARITY CARE PROVIDED TOTALED $1,174,000 IN 2020. 24402755 0 27248421 CAPITATION SERVICES - BEVERLY COMMUNITY HOSPITAL ASSOCIATION CONTRACTS WITH BLUE CROSS OF CALIFORNIA AND HEALTH NET OF CALIFORNIA TO PROVIDE INPATIENT AND OUTPATIENT HOSPITAL SERVICES AT FULL RISK TO ENROLLED MEDI-CAL BENEFICIARIES WHO ARE CONCURRENTLY ENROLLED WITH A LOCAL MEDICAL GROUP. ENROLLMENT DURING 2020 WAS 521,453 MEMBER MONTHS. 144343001 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 679 0 1 1072 1 0 0 0 0 0 0 0 0 0 0 0 0 X 13 12 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 CA X DANIEL WAY 3238375190 309 WEST BEVERLY BOULEVARD MONTEBELLO CA 90640 ALICE CHENG FACHE PRESIDENT & CEO 40.00 3.00 X 680584 0 44849 SABBIR DADABHAI VP OF FINANCE & CFO 40.00 3.00 X 244208 0 2905 CHARLENE CHU RN BSN ADMIN DIRECTOR, ACUTE CARE SERVICES 40.00 0.00 X 216687 0 19288 ROY C RORICK RADIOLOGY NUCLEAR MED. TECHNOLOGIST 40.00 0.00 X 199188 0 27878 JAMES JAWORSKI CHIEF INFO OFFICER THROUGH 10/2020 40.00 0.00 X 193740 0 21479 SUSAN M JUSTIN REGISTERED NURSE 36.00 0.00 X 202296 0 8901 LESTER FUJIMOTO VP OF DEV. AND COMMUNITY RELATIONS 5.00 35.00 X 190513 0 16609 JUNG-NA KIM REGISTERED NURSE 36.00 0.00 X 188510 0 18069 GEORGE HOLTZ MSHRM BSBN ADMIN DIRECTOR, HUMAN RESOURCES 40.00 0.00 X 182246 0 17346 ISMAEL MENDOZA REGISTERED NURSE 36.00 0.00 X 195565 0 2095 MARK LUEKEN RN MSN ADMIN DIRECTOR, QUALITY/RISK MGMT. 40.00 0.00 X 183609 0 9847 NANCY E LEE MSHCM BSN SENIOR VP OF OPERATIONS/CNO 40.00 0.00 X 174383 0 1418 LARRY PUGH FORMER VP OF FINANCE & CFO 0.00 0.00 X 155196 0 0 K LAWRENCE COHEN MD CHIEF MEDICAL OFFICER 40.00 0.00 X 153040 0 0 MICHAEL MARCUS DPM BOARD MEMBER 2.00 2.00 X 13000 0 0 LYLA EDDINGTON EDD RN CHAIRPERSON 2.00 2.00 X X 0 0 0 CARLOS MANUEL HARO PHD 1ST VICE CHAIRPERSON 2.00 2.00 X X 0 0 0 RENEE D MARTINEZ 2ND VICE CHAIRPERSON 2.00 2.00 X X 0 0 0 DENTON GUTHRIE CPA TREASURER 2.00 2.00 X X 0 0 0 GAUTAM GANGULY MD SECRETARY 2.00 2.00 X X 0 0 0 GARY R EINSTEIN ESQ BOARD MEMBER 2.00 2.00 X 0 0 0 GOHARIK GABRIEL BOARD MEMBER 2.00 3.00 X 0 0 0 RALPH HANSEN DMD BOARD MEMBER 2.00 3.00 X 0 0 0 JOHN HSU CPM CCIM BOARD MEMBER 2.00 2.00 X 0 0 0 AZIZ KHAN MD BOARD MEMBER 2.00 2.00 X 0 0 0 ROSEMARY OROZCO BOARD MEMBER 2.00 2.00 X 0 0 0 ALMA PEREZ SPHR BOARD MEMBER 2.00 2.00 X 0 0 0 3172765 0 190684 159 1 1 0 SODEXHO INC & ASSOCIATES 309 W BEVERLY BLVD MONTEBELLO CA 90640 FOOD & HOUSEKEEPING SERVICES 3737220 ACUTE DIALYSIS SERVICES LLC PO BOX 11065 WHITTIER CA 90603 DIALYSIS SERVICES 1413750 ALLIED UNIVERSAL SECURITY SERVICES 161 WASHINGTON ST 600 CONSHOHOCKEN PA 19428 SECURITY SERVICES 1117533 PARADIGM MEDICAL MANAGEMENT 2332 HAWTHORNE BLVD 301 TORRANCE CA 90505 WOUND CARE MANAGEMENT SERVICES 444774 LILIAN L GONG & ASSOCIATES INC 16800 NANETTE STREET GRANADA HILLS CA 91344 ACCOUNTING SERVICES 319740 62 699580 12395616 13095196 NET PATIENT SERVICE REVENUE 621990 138742883 138742883 PREMIUM REVENUE 621990 27248421 27248421 165991304 103748 103748 63974 0 63974 63974 63974 1578 0 1578 1578 1578 MISCELLANEOUS REVENUE 900099 521366 521366 REBATES & REFUNDS 900099 233460 233460 754826 180010626 165991304 0 924126 X 2158628 771272 1387356 155196 155196 52741837 47729404 5012433 285857 122832 163025 11120313 4811440 6308873 4784686 3921836 862850 639302 639302 2378635 2378635 60000 60000 23 23 43364478 39960255 3404223 384271 300456 83815 1366885 1366885 2438063 287582 2150481 1873 1873 3085878 3085878 210816 210816 9258742 2284829 6973913 2311384 2311384 MEDICAL SUPPLIES 19595971 19593371 2600 HOSPITAL FEE PROGRAM 18349163 18349163 EQUIPMENT RENTALS 3723097 2532518 1190579 4964180 3616170 1348010 183379278 144343001 39036277 0 10635282 9035454 15297431 31716233 22137318 21371409 3355903 3547724 1521339 1215562 203837484 112127657 96145872 91709827 1477194 1478646 3110194 4620986 49703351 45193582 203383884 209889423 22545383 16712616 0 14972820 60118473 59364303 10000000 11666420 29810988 29621332 122474844 132337491 X 80909040 77551932 80909040 77551932 203383884 209889423 X -3368652 -45995 57539 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 0 0 0 0 0 0 1 75338 75338 0 PART II-B, LINE 1: BEVERLY COMMUNITY HOSPITAL ASSOCIATION SUPPORTS CERTAIN INITIATIVES AND ISSUES THAT ARE HEALTHCARE RELATED AND CONSISTENT WITH ITS MISSION OF PROMOTING HEALTHCARE IN THE COMMUNITY. EXPENDITURES INCURRED TO SUPPORT THESE INITIATIVES MAY BE CONSIDERED TO BE LOBBYING EXPENDITURES. AN INDIRECT EXPENDITURE OF THE HOSPITAL'S MEMBERSHIP DUES PAID TO HOSPITAL ASSOCIATION OF SOUTHERN CALIFORNIA (HASC) WERE USED FOR LOBBYING ACTIVITIES. IN ADDITION, THE ORGANIZATION COMPENSATED A CONSULTANT $60,000 TO ASSIST IN HEALTHCARE RELATED LOBBYING ISSUES. 1398730 1398730 140687169 71265888 69421281 584120 584120 0 41893315 27941416 13951899 19274150 12336233 6937917 91709827 DUE FROM RELATED PARTIES 3781977 THIRD PARTY PAYOR RECEIVABLES 34352502 UNAMORTIZED LOAN COSTS 2859 MALPRACTICE/WORKER'S COMP INSURANCE RECEIVABLES 3912000 BENEFICIAL INTEREST IN AFFILIATE 2767420 OTHER RECEIVABLES 256414 DEPOSITS 120410 45193582 ACCRUED SELF-INSURANCE CLAIMS RESERVES 7584843 LEASE OBLIGATIONS 7940865 DUE TO RELATED PARTIES 3832679 MEDICAL CLAIMS LIABILITIES 5100699 SHARED RISK LIABILITY 2810026 DEFERRED EMPLOYER SOCIAL SECURITY TAX LIABILITY 2352220 29621332 X PART X, LINE 2: THE CORPORATION RECOGNIZES THE TAX EXPENSE OR PROVISION FROM UNCERTAIN TAX POSITIONS ONLY IF IT IS MORE LIKELY THAN NOT THAT THE TAX POSITIONS WILL BE SUSTAINED ON EXAMINATION BY THE TAX AUTHORITIES, BASED ON THE TECHNICAL MERITS OF THE POSITION. THE TAX BENEFIT IS MEASURED BASED ON THE LARGEST BENEFIT THAT HAS A GREATER THAN 50% LIKELIHOOD OF BEING REALIZED UPON ULTIMATE SETTLEMENT. 1 1 X 1 X 350.000000000000 1 X 450.000000000000 1 1 1 0 1 1 1173656 1173656 0.00640 81815363 66739564 15075799 0.08220 82989019 66739564 16249455 0.08860 1333220 1333220 0.00730 388454 388454 0.00210 6443577 2008151 4435426 0.02420 8165251 2008151 6157100 0.03360 91154270 68747715 22406555 0.12220 1 9853891 24581155 30236012 -5654857 X 1 1 1 1 BEVERLY HOSPITAL 309 WEST BEVERLY BOULEVARD MONTEBELLO CA 90640 WWW.BEVERLY.ORG 930000389 X X X BEVERLY HOSPITAL 1 0 0 1 X X X X X X X X X 19 1 0 0 1 X WWW.BEVERLY.ORG/ABOUT-US/IN-THE-COMMUNITY/ X 1 19 1 WWW.BEVERLY.ORG/ABOUT-US/IN-THE-COMMUNITY/ 0 1 X 350.000000000000 450.000000000000 X X X X X 1 1 X X X 1 X HTTPS://WWW.BEVERLY.ORG/PATIENTS/ X HTTPS://WWW.BEVERLY.ORG/PATIENTS/ X HTTPS://WWW.BEVERLY.ORG/PATIENTS/ X X X X X X 1 X 0 X X X X 1 X 0 0 BEVERLY HOSPITAL PART V, SECTION B, LINE 5: INTERVIEWS AND FOCUS GROUPS WERE USED TO GATHER INFORMATION AND OPINIONS FROM PERSONS WHO REPRESENT THE INTERESTS OF THE COMMUNITY SERVED BY THE HOSPITAL.FOURTEEN (14) INTERVIEWS WERE COMPLETED FROM JUNE THROUGH AUGUST 2019. COMMUNITY STAKEHOLDERS IDENTIFIED BY THE HOSPITAL WERE CONTACTED AND ASKED TO PARTICIPATE IN THE NEEDS ASSESSMENT. INTERVIEWEES INCLUDED INDIVIDUALS WHO ARE LEADERS AND/OR REPRESENTATIVES OF MEDICALLY UNDERSERVED, LOW-INCOME, AND MINORITY POPULATIONS, LOCAL HEALTH OR OTHER DEPARTMENTS OR AGENCIES THAT HAVE CURRENT DATA OR OTHER INFORMATION RELEVANT TO THE HEALTH NEEDS OF THE COMMUNITY. INPUT WAS OBTAINED FROM THE LOS ANGELES COUNTY DEPARTMENT OF PUBLIC HEALTH. THE IDENTIFIED STAKEHOLDERS WERE INVITED BY EMAIL TO PARTICIPATE IN A PHONE INTERVIEW. APPOINTMENTS FOR THE INTERVIEWS WERE MADE ON DATES AND TIMES CONVENIENT TO THE STAKEHOLDERS. AT THE BEGINNING OF EACH INTERVIEW, THE PURPOSE OF THE INTERVIEW IN THE CONTEXT OF THE NEEDS ASSESSMENT WAS EXPLAINED, THE STAKEHOLDERS WERE ASSURED THEIR RESPONSES WOULD REMAIN CONFIDENTIAL, AND CONSENT TO PROCEED WAS GIVEN. INTERVIEW QUESTIONS FOCUSED ON THE FOLLOWING TOPICS: (I) MAJOR HEALTH ISSUES IN THE COMMUNITY; (II) SOCIOECONOMIC, BEHAVIORAL, OR ENVIRONMENTAL FACTORS THAT IMPACT HEALTH IN THE COMMUNITY; (III) WHO IS MOST AFFECTED BY THE SIGNIFICANT NEEDS; (IV) ISSUES, CHALLENGES AND BARRIERS EXPERIENCED IN THE COMMUNITY; (V) POTENTIAL RESOURCES TO ADDRESS THE IDENTIFIED HEALTH NEEDS, SUCH AS SERVICES, PROGRAMS AND/OR COMMUNITY EFFORTS; AND (VI) ADDITIONAL COMMENTS AND CONCERNS.IN ADDITION, COMMUNITY FOCUS GROUPS WERE HELD IN JUNE, JULY AND AUGUST, 2019 AND ENGAGED 48 PERSONS. FOCUS GROUP QUESTIONS FOCUSED ON THE FOLLOWING TOPICS: (I) BIGGEST HEALTH NEEDS IN THE COMMUNITY; (II) CHALLENGES AND BARRIERS FACED IN ADDRESSING HEALTH NEEDS; (III) PRIORITIZATION OF HEALTH NEEDS; AND (IV) ADDITIONAL COMMENTS.A LIST OF THE INTERVIEW AND FOCUS GROUP PARTICIPANTS CAN BE FOUND WITHIN THE CHNA POSTED ON THE ORGANIZATION'S WEBSITE. BEVERLY HOSPITAL PART V, SECTION B, LINE 11: IN 2019, BEVERLY HOSPITAL CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) TO COMPLY WITH STATE AND FEDERAL REGULATIONS GUIDING TAX EXEMPT HOSPITALS. THE CHNA INCORPORATED DEMOGRAPHIC AND HEALTH DATA FOR THE COMMUNITIES SERVED BY THE HOSPITAL. SIGNIFICANT HEALTH NEEDS WERE IDENTIFIED FROM PRIMARY AND SECONDARY DATA SOURCES AS WELL AS INFORMATIONAL INTERVIEWS AND FOCUS GROUPS. INDICATORS ASSOCIATED WITH HEALTH WERE CONSIDERED HEALTH NEEDS WHEN THEY COMPARED UNFAVORABLY TO BENCHMARK DATA, SPECIFICALLY COUNTY OR STATE RATES OR HEALTHY PEOPLE 2020 OBJECTIVES. THE FOLLOWING HEALTH NEEDS WERE IDENTIFIED: (I) ACCESS TO HEALTH CARE; (II) CHRONIC DISEASES (ASTHMA, CANCER, DIABETES, HEART DISEASE, LIVER DISEASE, KIDNEY DISEASE); (III) DENTAL CARE; (IV) ECONOMIC INSECURITY; (V) MENTAL HEALTH; (VI) OVERWEIGHT AND OBESITY; (VII) PREVENTIVE PRACTICES (VACCINES AND SCREENINGS); (VIII) SUBSTANCE USE AND MISUSE; AND (IX) VIOLENCE/COMMUNITY SAFTERY.BEVERLY HOSPITAL PLANS TO ADDRESS THE SIGNIFICANT HEALTH NEEDS IDENTIFIED IN THE 2019 CHNA. APPLYING THE FOLLOWING CRITERIA, THE ORGANIZATION WAS ABLE TO ASSESS ITS ABILITY TO IMPACT THE IDENTIFIED AND PRIORITIZED HEALTH NEEDS. THESE CRITERIA INCLUDED: ORGANIZATIONAL CAPACITY, ESTABLISHED RELATIONSHIPS, ONGOING INVESTMENT, AND ACKNOWLEDGED COMPETENCIES AND EXPERTISE. AS A RESULT, BEVERLY HOSPITAL WILL ADDRESS THE FOLLOWING HEALTH NEEDS THROUGH A COMMITMENT OF COMMUNITY BENEFIT PROGRAMS AND CHARITABLE RESOURCES: (I) ACCESS TO HEALTH CARE: (II) CHRONIC DISEASES (INCLUDING HEALTHY EATING AND ACTIVE LIVING); (III) MENTAL HEALTH; AND (IV) PREVENTIVE CARE TO ADDRESS THE SIGNIFICANT HEALTH NEED OF "ACCESS TO HEALTH CARE", BEVERLY HOSPITAL WILL TAKE THE FOLLOWING ACTIONS: (I) PROVIDE FINANCIAL ASSISTANCE THROUGH BOTH FREE AND DISCOUNTED CARE FOR HEALTH CARE SERVICES, CONSISTENT WITH THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY; (II) PROVIDE TRANSPORTATION SUPPORT TO INCREASE ACCESS TO HEALTH CARE SERVICES; (III) OFFER INFORMATION AND ENROLLMENT ASSISTANCE IN THE COVERED CALIFORNIA HEALTH CARE EXCHANGE AND OTHER LOW-COST INSURANCE PROGRAMS AND PROVIDE INFORMATION ABOUT MEDICARE BENEFITS UPDATES; (IV) PURSUE FEDERALLY QUALIFIED HEALTH CARE STATUS FOR HOSPITAL-BASED CLINICS TO PROVIDE PRIMARY CARE SERVICES TO UNDERSERVED POPULATIONS; (V) PARTNER WITH BEVERLY URGENT CARE FACILITY IN MONTEBELLO MANAGED BY AME.TO ADDRESS THE SIGNIFICANT HEALTH NEED OF "CHRONIC DISEASES (INCLUDING HEALTHY EATING AND ACTIVE LIVING)", BEVERLY HOSPITAL WILL TAKE THE FOLLOWING ACTIONS: (I) THROUGH THE DIABETES CENTER, PROVIDE FREE DIABETES EDUCATION, HOST DIABETES AWARENESS EVENTS, INCLUDING BLOOD GLUCOSE SCREENING AND NUTRITION CLASSES; (II) OFFER CPR CLASSES; (III) THROUGH THE WOUND CARE CENTER, PROVIDE EDUCATION FOOT CARE SCREENINGS; (IV) HOST HEALTH AND WELLNESS FAIRS FOR SENIORS, INCLUDING SCREENINGS; (V) INCREASE CARDIAC AWARENESS THROUGH HEALTH EDUCATION AND SCREENING TESTS TO IDENTIFY CARDIAC DISEASE; (VI) CONTINUE PARTICIPATION AS A STEMI RECEIVING CENTER DESIGNATION WITH LA COUNTY; (VII) PROVIDE SUPPORT GROUPS TO ASSIST THOSE WITH CHRONIC DISEASES AND THEIR FAMILIES; (VIII) PROVIDE PUBLIC HEALTH EDUCATION IN THE MEDIA AND COMMUNITY HEALTH AWARENESS EVENTS TO ENCOURAGE HEALTHY BEHAVIORS AND PREVENT CHRONIC DISEASES; (IX) CONTINUE PRIMARY STROKE CENTER DESIGNATION WITH LA COUNTY; (X) PROVIDE EDUCATIONAL TOURS OF SUPERMARKETS TO PROMOTE HEALTHY FOOD CHOICES; AND (XI) SUPPORT LOCAL FARMERS MARKETS.TO ADDRESS THE SIGNIFICANT HEALTH NEED OF "MENTAL HEALTH", BEVERLY HOSPITAL WILL TAKE THE FOLLOWING ACTIONS: (I) OFFER COMMUNITY HEALTH EDUCATION, COMMUNITY LECTURES, PRESENTATIONS AND WORKSHOPS; (II) SUPPORT MULTISECTOR COLLABORATIVE EFFORTS THAT SUPPORT ACCESS TO MENTAL HEALTH SERVICES; (III) PROVIDE INCREASED ACCESS TO MENTAL HEALTH CARE THROUGH THE PROVISION OF TELE-PSYCH SERVICES; (IV) INCREASE COMMUNITY AWARENESS OF PREVENTION EFFORTS AND AVAILABILITY OF RESOURCES TO ADDRESS MENTAL HEALTH CONCERNS; (V) PURSUE FEDERALLY QUALIFIED HEALTH CARE STATUS FOR HOSPITAL-BASED CLINICS TO PROVIDE MENTAL HEALTH CARE SERVICES TO UNDERSERVED POPULATIONS; AND (VI) SUPPORT COMMUNITY COLLABORATION AND EDUCATION ON MENTAL HEALTH BY HOSTING THE BEVERLY HOSPITAL TASK FORCE ON HOMELESSNESS AND MENTAL HEALTH.TO ADDRESS THE SIGNIFICANT HEALTH NEED OF "PREVENTIVE PRACTICES", BEVERLY HOSPITAL WILL TAKE THE FOLLOWING ACTIONS: (I) PROVIDE FREE HEALTH SCREENINGS; (II) PROVIDE EDUCATION AND RESOURCES FOCUSED ON HEALTHY LIVING AND DISEASE PREVENTION TO BE OFFERED IN ENGLISH AND SPANISH; (III) PROVIDE EDUCATION TO TEENS ON ABSTINENCE, BIRTH CONTROL, SEXUALLY TRANSMITTED DISEASES AND PREGNANCY PREVENTION; (IV) OFFER FREE CHILDHOOD IMMUNIZATIONS AND ADULT FLU SHOTS; (V) PROVIDE TB TESTING; (VI) OFFER BREAST AND CERVICAL CANCER SCREENINGS AT LOW AND NO-COST FOR WOMEN THROUGH THE FAMILY PACT AND EVERY WOMAN COUNTS PROGRAMS; AND (VI) PURSUE FEDERALLY QUALIFIED HEALTH CARE STATUS FOR HOSPITAL-BASED CLINICS TO PROVIDE PRIMARY CARE SERVICES TO UNDERSERVED POPULATIONS.BEVERLY HOSPITAL WILL MONITOR AND EVALUATE THE PROGRAMS AND ACTIVITIES OUTLINED ABOVE. THE HOSPITAL HAS A SYSTEM THAT TRACKS THE IMPLEMENTATION OF THE STRATEGIES AND DOCUMENTS THE ANTICIPATED IMPACT. THE REPORTING PROCESS INCLUDES THE COLLECTION AND DOCUMENTATION OF TRACKING MEASURES, SUCH AS THE NUMBER OF PEOPLE REACHED/SERVED AND COLLABORATIVE EFFORTS TO ADDRESS HEALTH NEEDS. AN EVALUATION OF THE IMPACT OF THE HOSPITAL'S ACTIONS TO ADDRESS THESE SIGNIFICANT HEALTH NEEDS WILL BE REPORTED IN THE NEXT SCHEDULED CHNA.TAKING EXISTING HOSPITAL AND COMMUNITY RESOURCES INTO CONSIDERATION, BEVERLY HOSPITAL WILL NOT DIRECTLY ADDRESS THE REMAINING HEALTH NEEDS IDENTIFIED IN THE CHNA INCLUDING: DENTAL CARE, ECONOMIC INSECURITY, SUBSTANCE USE AND MISUSE, AND VIOLENCE/COMMUNITY SAFETY. BEVERLY HOSPITAL HAS ELECTED TO CONCENTRATE ON THOSE HEALTH NEEDS THAT CAN MOST EFFECTIVELY BE ADDRESSED, GIVEN THE ORGANIZATION'S CAPABILITIES. THE HOSPITAL HAS INSUFFICIENT RESOURCES TO EFFECTIVELY ADDRESS ALL THE IDENTIFIED NEEDS AND, IN SOME CASES, THE NEEDS ARE CURRENTLY ADDRESSED BY OTHERS IN THE COMMUNITY. BEVERLY HOSPITAL WILL CONTINUE TO LOOK FOR OPPORTUNITIES TO ADDRESS COMMUNITY NEEDS, WHERE WE CAN MAKE A MEANINGFUL CONTRIBUTION. 1 1 - WOMEN'S PAVILION & BREAST CENTER 101 E BEVERLY BLVD MONTEBELLO CA 90640 OUTPATIENT CLINIC PART I, LINE 7: BEVERLY HOSPITAL USES COST TO CHARGE RATIO TO DETERMINE THE AMOUNTS ON SCHEDULE H, PART I, LINE 7B. COST ACCOUNTING WAS USED TO DETERMINE THE AMOUNTS ON PART I, LINES 7A, 7E, 7F, AND 7G. PART II, COMMUNITY BUILDING ACTIVITIES: THE FOLLOWING NARRATIVE OUTLINES THE COMMUNITY BUILDING ACTIVITIES BCHA UNDERTOOK IN 2020; EXPENSES COULD NOT BE EASILY QUANTIFIED FOR PRESENTATION IN SCHEDULE H, PART II:ECONOMIC DEVELOPMENT: IN 2020, THE HOSPITAL PROVIDED SUPPORT TO THE CHAMBERS OF COMMERCE IN MONTEBELLO, PICO RIVERA, ROSEMEAD, AND WHITTIER.BEVERLY HOSPITAL SERVED AS A TRAINING SITE FOR STUDENTS INTERESTED IN A CAREER IN HEALTH CARE THROUGH THE APPLIED TECHNOLOGY CENTER MONTEBELLO HIGH SCHOOL PATHWAYS PROGRAM.COMMUNITY SUPPORT: THE HOSPITAL PARTICIPATED IN COMMUNITY HEALTH FAIRS OR EVENTS AS A WAY TO CONNECT WITH THE COMMUNITY AND PROVIDE HEALTH EDUCATION, SCREENINGS, AND OR INFORMATION ABOUT SERVICES. SCREENINGS THAT WERE OFFERED INCLUDED GLUCOSE, BLOOD PRESSURE, SPIROMETRY, VASCULAR, AND OTHERS.LEADERSHIP DEVELOPMENT AND TRAINING FOR COMMUNITY MEMBERS: ACCREDITED BY THE AMERICAN ASSOCIATION OF DIABETES EDUCATORS, BEVERLY HOSPITAL PROVIDED EDUCATION ON PREVENTION, MANAGEMENT, AND TREATMENT OF DIABETES TO THE COMMUNITY. THROUGH THE SWEET SUCCESS PROGRAM, THE CENTER OFFERED COUNSELING TO MOTHERS WHO HAVE DEVELOPED GESTATIONAL DIABETES DURING THEIR PREGNANCIES. DIABETES COUNSELING WAS OFFERED IN ENGLISH AND SPANISH. ADDITIONALLY, MONTHLY LECTURES CALLED DIABETES WELLNESS HOUR, WHICH TAUGHT PARTICIPANTS HOW TO LIVE A HEALTHY LIFESTYLE WHILE WITH DIABETES, WERE CONDUCTED.COALITION BUILDING: BEVERLY HOSPITAL EXTENDED SUPPORT, SUCH AS SERVICES, IN-KIND DONATIONS, FINANCIAL CONTRIBUTIONS, AND DONATED SPACE, TO LIKE-MINDED COMMUNITY ORGANIZATIONS WITH SIMILAR COMMUNITY HEALTH GOALS. IN ADDITION, THE HOSPITAL CONTINUED TO HOST ITS TASK FORCE MEETINGS TO ADDRESS ISSUES WITH HOMELESSNESS AND MENTAL HEALTH.COMMUNITY HEALTH IMPROVEMENT ADVOCACY: IN PARTNERSHIP WITH SOUTH BAY HEALTH AND INSURANCE SERVICES (SBHIS) AND THE LOS ANGELES COUNTY DEPARTMENT OF PUBLIC HEALTH, BEVERLY HOSPITAL PROVIDED ENROLLMENT ASSISTANCE TO PATIENTS FOR NO COST OR LOWCOST HEALTH INSURANCE COVERAGE PROGRAMS.WORKFORCE DEVELOPMENT: THROUGHOUT THE YEAR, BEVERLY HOSPITAL PROVIDED CONTINUING EDUCATION OPPORTUNITIES FOR HEALTH PROFESSIONALS TO STAY UP TO DATE ON NEW MEDICAL AND SAFETY ADVANCEMENTS. AS A RESULT, THEY CAN BETTER ADDRESS COMMUNITY HEALTH AND WELLNESS NEEDS. EXAMPLES INCLUDED STROKE INFORMATION UPDATES AND EMPLOYEE SAFETY TRAINING. THE HOSPITAL ALSO SERVED AS A SITE FOR NURSING STUDENT TRAINING.OTHER: TO HELP INCREASE ACCESSIBILITY TO MOBILE TESTING SITES, BEVERLY HOSPITAL COLLABORATED WITH LOS ANGELES COUNTY SUPERVISOR HILDA L. SOLIS TO LAUNCH AN ON-SITE COVID-19 DRIVE THROUGH TESTING CLINIC. OVER THE COURSE OF 5 WEEKS, THE CLINIC PROVIDED A TOTAL OF 1,984 COVID-19 TESTS. PART III, LINE 2: GENERALLY, PATIENTS WHO ARE COVERED BY THIRD-PARTY PAYORS ARE RESPONSIBLE FOR RELATED DEDUCTIBLES AND COINSURANCE, WHICH VARY IN AMOUNT. THE HOSPITAL ALSO PROVIDES SERVICES TO UNINSURED PATIENTS, AND OFFERS THOSE UNINSURED PATIENTS A DISCOUNT, EITHER BY POLICY OR LAW, FROM STANDARD CHARGES. THE HOSPITAL ESTIMATES THE TRANSACTION PRICE FOR PATIENTS WITH DEDUCTIBLES AND COINSURANCE AND FROM THOSE WHO ARE UNINSURED BASED ON HISTORICAL EXPERIENCE AND CURRENT MARKET CONDITIONS. THE INITIAL ESTIMATE OF THE TRANSACTION PRICE IS DETERMINED BY REDUCING THE STANDARD CHARGE BY ANY CONTRACTUAL ADJUSTMENTS, DISCOUNTS, AND IMPLICIT PRICE CONCESSIONS. SUBSEQUENT CHANGES TO THE ESTIMATE OF THE TRANSACTION PRICE ARE GENERALLY RECORDED AS ADJUSTMENTS TO PATIENT SERVICE REVENUE IN THE PERIOD OF THE CHANGE. SUBSEQUENT CHANGES THAT ARE DETERMINED TO BE THE RESULT OF AN ADVERSE CHANGE IN THE PATIENT'S ABILITY TO PAY ARE RECORDED AS BAD DEBT EXPENSE. PART III, LINE 4: THE FOOTNOTE IN THE AUDITED FINANCIAL STATEMENTS (ATTACHED TO THIS FORM 990) WHICH ADDRESSES "BAD DEBT EXPENSE" CAN BE FOUND ON PAGE 13 OF THE AUDITED FINANCIAL STATEMENTS. PART III, LINE 8: A COST TO CHARGE RATIO IS USED TO DETERMINE THE MEDICACRE ALLOWABLE COSTS OF CARE ON SCHEDULE H, PART III, LINE 6.IT IS THE HOSPITAL'S BELIEF THAT THE SHORTFALL REFLECTED ON PART III, LINE 7 SHOULD BE CONSIDERED A COMMUNITY BENEFIT. THE IRS COMMUNITY BENEFIT STANDARD INCLUDES THE PROVISION OF CARE TO THE ELDERLY AND MEDICARE PATIENTS. MEDICARE SHORTFALLS MUST BE ABSORBED BY THE HOSPITAL IN ORDER TO CONTINUE TREATING THE ELDERLY IN THE HOSPITAL'S COMMUNITY. THE HOSPITAL PROVIDES CARE REGARDLESS OF THIS SHORTFALL AND THEREBY RELIEVES THE FEDERAL GOVERNMENT OF THE BURDEN OF PAYING THE FULL COST FOR MEDICARE BENEFICIARIES. CARING FOR MEDICARE PATIENTS FULFILLS A COMMUNITY NEED AND RELIEVES A GOVERNMENT BURDEN AS THESE PATIENTS TYPICALLY HAVE LOW AND/OR FIXED INCOMES. MEDICARE DOES NOT PROVIDE SUFFICIENT REIMBURSEMENT TO COVER THE COST OF PROVIDING CARE FOR THESE PATIENTS. PART III, LINE 9B: PATIENTS IN THE PROCESS OF QUALIFYING FOR GOVERNMENT OR HOSPITAL LOW-INCOME FINANCIAL ASSISTANCE PROGRAMS WILL NOT BE ASSIGNED TO COLLECTIONS PRIOR TO 150 DAYS FROM THE DATE OF INITIAL BILLING. ADDITIONALLY, LOW-INCOME PATIENTS, WHO AT THE SOLE DISCRETION OF THE HOSPITAL ARE REASONABLY COOPERATING TO SETTLE AN OUTSTANDING HOSPITAL BILL, WILL NOT BE SENT TO AN OUTSIDE COLLECTION AGENCY IF DOING SO WOULD NEGATIVELY IMPACT THE PATIENT'S CREDIT. PART VI, LINE 2: TO CONTINUE PROVIDING OUTSTANDING HEALTHCARE SERVICES AND VALUABLE COMMUNITY PROGRAMS, BEVERLY HOSPOITAL EVALUATES THE NEEDS OF THE COMMUNITY ON AN ON-GOING BASIS THROUGH A COMMUNITY HEALTH NEEDS ASSESSMENT, AND PLANS FOR THE FUTURE ACCORDINGLY. THE 2019 COMMUNITY NEEDS ASSESSMENT WAS DEVELOPED THROUGH A COMBINED QUANTITATIVE AND QUALITATIVE INFORMATION BASED ON REVIEW AND ANALYSIS OF DEMOGRAPHIC TRENDS, ECONOMIC TRENDS, HEALTH CONDITIONS, FAMILY AND COMMUNITY ISSUES, EDUCATION AND YOUTH DEVELOPMENT ISSUES, SENIOR SERVICES ISSUES AND COMMUNITY INPUT. THE HOSPITAL HELD FOCUS GROUP SESSIONS AND A SURVEY WITH REPRESENTATIVES FROM A VARIETY OF COMMUNITY-SERVING ORGANIZATIONS TO IDENTIFY KEY THEMES.ADDITIONALLY, OFTEN BEVERLY HOSPITAL TAKES ITS SERVICES OUT OF THE WALLS OF THE HOSPITAL DIRECTLY INTO THE COMMUNITY. OUR OUTREACH ACTIVITIES HELP US TO OFFER A HEALTHIER LIFESTYLE THROUGH HEALTH SCREENINGS, PHYSICIAN LECTURES, IMMUNIZATIONS CLINICS, NUTRITION PROGRAMS, MATERNITY EDUCATION, CHILDREN AND SENIORS PROGRAMS, AND MORE. PART VI, LINE 3: PUBLIC NOTICES ARE POSTED OF THE FINANCIAL ASSISTANCE PROGRAMS THAT ARE AVAILABLE IN THE HIGH VOLUME INPATIENT, OUTPATIENT, AND EMERGENCY SERVICE AREAS OF THE HOSPITAL. NOTICES ARE ALSO POSTED IN THE PATIENT FINANCIAL AND COLLECTION DEPARTMENTS. THESE NOTICES INCLUDE CONTACT INFORMATION ON HOW A PATIENT MAY OBTAIN MORE INFORMATION ON FINANCIAL ASSISTANCE AS WELL AS WHERE TO APPLY FOR SUCH ASSISTANCE. PART VI, LINE 4: BEVERLY HOSPITAL IS LOCATED AT 309 WEST BEVERLY BOULEVARD IN MONTEBELLO, CA 90640. THE HOSPITAL SERVICE AREA INCLUDES 11 CITIES AND 13 ZIP CODES: BELL/BELL GARDENS (90201); COMMERCE (90040); EAST LOS ANGELES (90022, 90023, 90063); EL MONTE (91732); MONTEBELLO (90640); MONTEREY PARK (91754, 91755); PICO RIVERA (90660); ROSEMEAD (91770); SOUTH EL MONTE (91733); AND WHITTIER (90601).THE POPULATION OF THE BEVERLY HOSPITAL SERVICE AREA IS 711,482. FROM 2012 TO 2017, THE POPULATION INCREASED BY 1.3%, WHICH IS LOWER THAN THE 2.7% INCREASE IN POPULATION COUNTYWIDE DURING THE SAME PERIOD. OF THE POPULATION, 49.5% IS MALE AND 50.5% ARE FEMALE. CHILDREN AND YOUTH, AGES 0-17, MAKE UP 24.4% OF THE POPULATION, 63% OF THE POPULATION IS ADULTS AGED 18-64, AND 12.6% OF THE POPULATION ARE SENIORS AGED 65 AND OVER. THE SERVICE AREA HAS A HIGHER PERCENTAGE OF CHILDREN AND YOUTH, AGES 0 TO 24, AND ELDERLY, 85 AND UP, THAN THE COUNTY.IN THE HOSPITAL SERVICE AREA, 76.4% OF THE POPULATION IS HISPANIC/LATINO, 17.4% ARE ASIAN, 4.8% ARE WHITE, AND .6% ARE BLACK/AFRICAN AMERICAN. THE REMAINING .9% ARE AMERICAN INDIAN/ALASKAN NATIVE, NATIVE HAWAIIAN/PACIFIC ISLANDER, AND OTHER OR MULTIPLE RACES. THERE IS A HIGHER PERCENTAGE OF LATINOS AND ASIANS, AND A LOWER PERCENTAGE OF WHITES AND BLACKS/AFRICANS AMERICANS IN THE HOSPITAL SERVICE AREA THAN FOUND IN THE COUNTY. IN THE SERVICE AREA, SPANISH IS SPOKEN IN THE HOME AMONG 63.5% OF THE POPULATION, ENGLISH IS SPOKEN IN THE HOME AMONG 20.3% OF THE POPULATION, 15.3% OF THE POPULATION SPEAKS AN ASIAN LANGUAGE, AND .7% OF THE POPULATIONS SPEAKS AN INDO-EUROPEAN LANGUAGE.THE SERVICE AREA HAS A SLIGHTLY HIGHER RATE OF POVERTY (19.3%) THAN FOUND IN THE COUNTY (17%). LEVELS OF LOW-INCOME (DEFINED AS EARNING LESS THAN 200% OF THE FPL) ARE 48.5% SERVICE-AREA WIDE, WHICH IS HIGHER THAN THE COUNTY AND STATE RATES. IN ADDITION, 29.1% OF SERVICE AREA CHILDREN (UNDER 18 YEARS OLD) ARE LIVING IN POVERTY, WHICH IS HIGHER THAN COUNTY AND STATE RATES.FOR ADDITIONAL POPULATION STATISTICS AND BENCHMARKS, PLEASE REFERENCE THE COMMUNITY HEALTH NEEDS ASSESSMENT POSTED ON THE ORGANIZATION'S WEBSITE). PART VI, LINE 5: OTHER INFORMATION IMPORTANT TO DESCRIBING HOW THE ORGANIZATION'S HOSPITAL FACILITIES OR OTHER HEALTH CARE FACILITIES FURTHER ITS EXEMPT PURPOSE BY PROMOTING THE HEALTH OF THE COMMUNITY INCLUDE: (I) THE BOARD OF DIRECTORS IS MADE UP OF PRIMARILY OF MEMBERS OF THE SURROUNDING COMMUNITY WHO ARE NOT PAID BY BEVERLY HOSPITAL; (II) THE ORGANIZATION EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN ITS COMMUNITY FOR, DEPENDING ON NEED; AND (III) SURPLUS FUNDS ARE APPLIED TO IMPROVE PATIENT CARE AND MEDICAL EDUCATION.ADDITIONALLY, BEVERLY HOSPITAL HAS AN ARRAY OF COMMUNITY OUTREACH PROGRAMS WHICH HELP TO PROMOTE THE HEALTH OF ITS SURROUNDING COMMUNITY. THESE PROGRAMS INCLUDE: FREE CHILDHOOD IMMUNIZATIONS FOR NEWBORNS TO THE AGE OF 18; MATERNITY CLASSES AND EVENTS; KIDSFIT AND TEENSFIT PROGRAMS, WHICH ARE DESIGNED TO HELP OVERWEIGHT KIDS DEVELOP GOOD EATING AND EXERCISE HABITS; A 50+ CONNECTION PROGRAM, WHICH PROVIDES REDUCED RATES ON PRESCRIPTIONS, MEDICAL EQUIPMENT, LEGAL COUNSELING, DENTAL AND VISION SERVICES, AND SOCIAL ACTIVITIES; SUPPORT GROUPS (GRIEF, ALZHEIMERS AND DEMENTIA, CAREGIVERS); AND VARIOUS HEALTH EDUCATION & SCREENINGS. PART VI, LINE 7, REPORTS FILED WITH STATES CA X X X X X 1 0 0 0 0 1 0 1 0 ALICE CHENG FACHE PRESIDENT & CEO 464363 0 208781 0 7440 0 1401 0 43448 0 725433 0 0 0 SABBIR DADABHAI VP OF FINANCE & CFO 237008 0 0 0 7200 0 0 0 2905 0 247113 0 0 0 CHARLENE CHU RN BSN ADMIN DIRECTOR, ACUTE CARE SERVICES 216447 0 0 0 240 0 1640 0 17648 0 235975 0 0 0 ROY C RORICK RADIOLOGY NUCLEAR MED. TECHNOLOGIST 199188 0 0 0 0 0 1552 0 26326 0 227066 0 0 0 JAMES JAWORSKI CHIEF INFO OFFICER THROUGH 10/2020 177819 0 0 0 15921 0 0 0 21479 0 215219 0 0 0 SUSAN M JUSTIN REGISTERED NURSE 202296 0 0 0 0 0 1189 0 7712 0 211197 0 0 0 LESTER FUJIMOTO VP OF DEV. AND COMMUNITY RELATIONS 183073 0 0 0 7440 0 1389 0 15220 0 207122 0 0 0 JUNG-NA KIM REGISTERED NURSE 188510 0 0 0 0 0 1433 0 16636 0 206579 0 0 0 GEORGE HOLTZ MSHRM BSBN ADMIN DIRECTOR, HUMAN RESOURCES 182246 0 0 0 0 0 0 0 17346 0 199592 0 0 0 ISMAEL MENDOZA REGISTERED NURSE 195565 0 0 0 0 0 0 0 2095 0 197660 0 0 0 MARK LUEKEN RN MSN ADMIN DIRECTOR, QUALITY/RISK MGMT. 180009 0 0 0 3600 0 0 0 9847 0 193456 0 0 0 NANCY E LEE MSHCM BSN SENIOR VP OF OPERATIONS/CNO 168537 0 0 0 5846 0 0 0 1418 0 175801 0 0 0 LARRY PUGH FORMER VP OF FINANCE & CFO 0 0 0 0 155196 0 0 0 0 0 155196 0 0 0 K LAWRENCE COHEN MD CHIEF MEDICAL OFFICER 153040 0 0 0 0 0 0 0 0 0 153040 0 0 0 PART I, LINE 4A LARRY PUGH RECEIVED A SEVERANCE PAYMENT OF $155,196, WHICH HAS BEEN REPORTED WITHIN "OTHER REPORTABLE COMPENSATION" ON SCHEDULE J, PART II, COLUMN (B)(III). PART I, LINE 6 THE ORGANIZATION PAYS BONUSES TO CERTAIN EMPLOYEES OF THE ORGANIZATION CONTINGENT ON VARIOUS PERFORMANCE MEASURES, ONE OF WHICH INCLUDES THE ORGANIZATION MEETING BUDGETED FINANCIAL MEASURES. PART I, LINE 7 THE ORGANIZATION PAYS BONUSES TO CERTAIN EMPLOYEES OF THE ORGANIZATION FOR WHICH INDIVIDUALS UTILIZE DISCRETION IN EVALUATING PERFORMANCE MEASURES (IN PART) AND TO DETERMINE THE AMOUNT OF BONUS PAYMENT TO BE PAID. A CALIFORNIA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITY 680164610 13080SLL6 2015-12-02 41768337 IMPROVEMENT, RENOVATION, AND EQUIPPING HOSPITAL/REFUND BOND DATED 9/30/2015 0 0 0 B CALIFORNIA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITY 680164610 13080SRG1 2017-05-09 21043908 IMPROVEMENT, RENOVATION, AND EQUIPPING HOSPITAL 0 0 0 A 1540000 41768337 537891 768338 11364482 29097626 2016 1 0 1 1 B 21043908 396800 20689405 2018 0 0 1 1 A 0 0 1 1 0 0.00000 0.00000 0.00000 0 0 1 B 0 0 1 1 0 0.00000 0.00000 0.00000 0 0 1 A 0 1 0 0 0 0 0 0 1 B 0 1 0 0 0 0 0 0 1 A 1 B 1 FORM 990, PART VI, SECTION B, LINE 11B A PUBLIC ACCOUNTING FIRM PREPARES THE FORM 990 IN CONJUNCTION WITH THE ORGANIZATION'S ACCOUNTING AND FINANCE STAFF. A DRAFT FORM 990 IS THEN REVIEWED BY THE CONTROLLER AND CEO; ADJUSTMENTS ARE MADE, AS NECESSARY. THE COMPLETED FORM 990 IS THEN REVIEWED IN ITS ENTIRETY BY ALL MEMBERS OF THE GOVERNING BOARD BEFORE IT IS FILED WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C ALL MEMBERS OF THE BOARD OF DIRECTORS, OFFICERS, AND KEY EMPLOYEES COMPLETE A QUESTIONNAIRE ANNUALLY. QUESTIONNAIRES SUBMITTED BY OFFICERS (OTHER THAN THE PRESIDENT/CEO) AND KEY EMPLOYEES ARE REVIEWED BY THE PRESIDENT/CEO. QUESTIONNAIRES SUBMITTED BY THE PRESIDENT/CEO AND DIRECTORS ARE REVIEWED BY THE CHAIRMAN OF THE BOARD OF DIRECTORS. ALL DISCLOSED CONFLICTS ARE REPORTED TO THE BOARD OF DIRECTORS. IF A CONFLICT IS IDENTIFIED, THE CONFLICTED INDIVIDUAL WILL NOT PARTICIPATE IN DELIBERATIONS AND DECISIONS IMPACTING THE CONFLICTED MATTER. FORM 990, PART VI, SECTION B, LINE 15 CURRENT COMPARATIVE COMPENSATION INFORMATION IS OBTAINED FROM AN INDEPENDENT FIRM, MOST RECENTLY IN 2020. THE PRESIDENT & CEO EVALUATION COMMITTEE OF THE BOARD OF DIRECTORS USES THIS INFORMATION AND ITS EVALUATION OF PERFORMANCE TO SET THE ANNUAL COMPENSATION OF THE PRESIDENT/CEO. DOCUMENTATION OF THIS PROCESS IS RETAINED BY THE CHAIRMAN OF THE BOARD OF DIRECTORS. THE PRESIDENT & CEO EVALUATION COMMITTEE ALSO SETS THE TARGET LEVEL OF ANNUAL COMPENSATION FOR OFFICERS AND KEY EMPLOYEES, WHICH IS NOT TO EXCEED THE 50TH PERCENTILE OF THE MARKET ANALYSIS PERFORMED BY THE INDEPENDENT COMPENSATION CONSULTANTS. THE PRESIDENT/CEO USES THE SAME PROCESS TO DETERMINE THE ANNUAL COMPENSATION ADJUSTMENTS OF OTHER OFFICERS AS WELL AS KEY EMPLOYEES. THE PRESIDENT/CEO DISCUSS THESE PROPOSED ANNUAL COMPENSATION ADJUSTMENTS WITH THE PRESIDENT & CEO EVALUATION COMMITTEE OF THE BOARD OF DIRECTORS. DOCUMENTATION OF THIS PROCESS IS RETAINED BY THE PRESIDENT/CEO. FORM 990, PART VI, SECTION C, LINE 19 REQUESTS TO VIEW THE CONFLICT OF INTEREST POLICY SHOULD BE MADE TO ADMINISTRATION, AND ARE MADE AVAILABLE UPON REQUEST. THE HOSPITAL DOES NOT MAKE EITHER THE GOVERNING/ORGANIZING DOCUMENTS OR AUDITED FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. FORM 990, PART IX, LINE 11G CAPITATED MEDICAL SERVICES: PROGRAM SERVICE EXPENSES 22,389,550. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 22,389,550. PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 8,499,041. MANAGEMENT AND GENERAL EXPENSES 1,011,015. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 9,510,056. PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 9,071,664. MANAGEMENT AND GENERAL EXPENSES 2,393,208. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 11,464,872. FORM 990, PART XI, LINE 9: CHANGE IN BENEFICIAL INTEREST IN BEVERLY HOSPITAL FOUNDATION 57,539. MONTEBELLO COMMUNITY HEALTH SERVICES INC 309 WEST BEVERLY BOULEVARD MONTEBELLO CA 90640 953823550 SUPPORT BEVERLY COMMUNITY HOSPITAL ASSOCIATION CA 501(C)(3) LINE 12B, II BEVERLY COMMUNITY HOSPITAL ASSOCIATION 1 BEVERLY HOSPITAL FOUNDATION 309 WEST BEVERLY BOULEVARD MONTEBELLO CA 90640 237429685 SUPPORT BEVERLY COMMUNITY HOSPITAL ASSOCIATION CA 501(C)(3) LINE 7 BEVERLY COMMUNITY HOSPITAL ASSOCIATION 1 BEVERLY MSO 309 WEST BEVERLY BOULEVARD MONTEBELLO CA 90640 352596953 MANAGEMENT SERVICE ORGANIZATION CA N/A C 1 0 0 1 1 1 0 0 0 0 0 1 0 1 1 1 0 1 0 0 BEVERLY HOSPITAL FOUNDATION C 699580 BOOK VALUE BEVERLY HOSPITAL FOUNDATION D 353929 BOOK VALUE BEVERLY HOSPITAL FOUNDATION O 178963 BOOK VALUE MONTEBELLO COMMUNITY HEALTH SERVICES INC D 3428048 BOOK VALUE MONTEBELLO COMMUNITY HEALTH SERVICES INC E 3832679 BOOK VALUE MONTEBELLO COMMUNITY HEALTH SERVICES INC K 248754 BOOK VALUE